Evaluation of the feasibility and effectiveness of trauma-focused cognitive behavioural therapy for children and youth in Ukraine during the war

Abstract

BACKGROUND: The large-scale Russian invasion of Ukraine in early 2022 resulted in a humanitarian crisis with hundreds of thousands of children exposed to traumatic events. To date, trauma-focused evidence-based treatments (EBTs) for children and youth have not been systematically evaluated and implemented in Ukraine. This study aims at evaluating 1) the feasibility of a training program for Ukrainian therapists on Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) and 2) the feasibility and effectiveness of the treatment for children, youth, and their families in and from Ukraine during the ongoing war. METHODS: The project "TF-CBT Ukraine" was implemented between March 2022 and May 2024, in close collaboration with local and international partners. Therapists completed questionnaires before/after the training, and patients were asked to complete a measure on PTSD before and after treatment. RESULTS: Altogether 138 therapists started the training program and 44.9% were certified as TF-CBT therapists. The program completers reported overall high satisfaction with the training program, a positive change in their attitude towards EBTs and trauma-related knowledge gain. The patients (age 3-21, 37% male) reported significant improvement in symptoms of PTSD at the end of treatment with large pre-post effect sizes for DSM-5 PTSD (d(selfreport) = 2.36; d(caregiverreport) = 2.27), ICD-11 PTSD (d(selfreport) = 1.97; d(caregiverreport) = 1.77), ICD-11 CPTSD (d(selfreport) = 2.04; d(caregiverreport) = 1.99), and DSM-5 pre-school PTSD (d(caregiverreport) = 3.14). CONCLUSIONS: The results of this study are promising in regard to the general implementation of trauma-focused EBTs in active conflict areas. Future studies need to replicate these findings in a randomized controlled study design.